moral support.. or a good cocktail recipe needed

[Dep.Weigel]

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Ok - let me introduce myself as a lurker and former poster (a few years ago, but I forgotten my id and password twice and since then have been happy to just read other's postings). But now I need help. Now I am a third year and life is... well... lets just say I started with Medicine and I am now half way through OB/GYN and I am trying, really trying to be optimistic and up beat because I know the time will go by faster, but honestly I am beginning to dread everyday, and every day is getting L-o-n-g-e-r...

I read in a book on choosing specialties that pathology was like "being able to skim the intellectual cream off of the top of medicine". That statement more than any other I have come across or thought of, sums up why I am so enamored with this field. That being said, my frustration these days stems from the fact that I have come to believe that there is no quicker way to kill curiosity than empirical treatment, and that seems to be everything that clinical medicine is based on!! Everything is management. As much (or more) time management than patient management. I am exhausted and afraid by the time I take my pathology elective next fall I will be reduced to a barely functioning automaton... I know that there is a light at the end of the tunnel - but lately it?s just been hard to keep up. How did you guys get through? How did you keep your spirits and interests alive during a year that seems for the most part so removed from your future career? I know misery loves company, but I really need some words of encouragement here - the other day I actually entertained the thought of just driving straight home when I was set to get food for team (a job which I actually had gladly volunteered for!). I can't tell how much of what I feel is sleep deprivation (or that hangover you get from sleeping TOO much when you are trying to make up for it), how much is disillusionment and how much is just plain aggravation at having to constantly "show enthusiasm". Ack.

Sorry for the rant. Just tell me it gets better after this...

S.

 

[b&ierstiefel]

Ok - let me introduce myself as a lurker and former poster (a few years ago, but I forgotten my id and password twice and since then have been happy to just read other's postings). But now I need help. Now I am a third year and life is... well... lets just say I started with Medicine and I am now half way through OB/GYN and I am trying, really trying to be optimistic and up beat because I know the time will go by faster, but honestly I am beginning to dread everyday, and every day is getting L-o-n-g-e-r...

I read in a book on choosing specialties that pathology was like "being able to skim the intellectual cream off of the top of medicine". That statement more than any other I have come across or thought of, sums up why I am so enamored with this field. That being said, my frustration these days stems from the fact that I have come to believe that there is no quicker way to kill curiosity than empirical treatment, and that seems to be everything that clinical medicine is based on!! Everything is management. As much (or more) time management than patient management. I am exhausted and afraid by the time I take my pathology elective next fall I will be reduced to a barely functioning automaton... I know that there is a light at the end of the tunnel - but lately it?s just been hard to keep up. How did you guys get through? How did you keep your spirits and interests alive during a year that seems for the most part so removed from your future career? I know misery loves company, but I really need some words of encouragement here - the other day I actually entertained the thought of just driving straight home when I was set to get food for team (a job which I actually had gladly volunteered for!). I can't tell how much of what I feel is sleep deprivation (or that hangover you get from sleeping TOO much when you are trying to make up for it), how much is disillusionment and how much is just plain aggravation at having to constantly "show enthusiasm". Ack.

Sorry for the rant. Just tell me it gets better after this...

S.

Many of us pathologists-to-be have endured the hell of 3rd year. I feel your pain as on many of my rotations, I came in thinking that I wanted to shoot myself. Floor medicine is very mind-numbing because of the whole cover-your-ass mentality behind it. I vowed to never work on the floors again after medical school and God be willing, I shall keep this vow!

As for your question of what got me through the hell we call 3rd year...I tried my very best to NOT live and breathe medicine. During the days, my fellow students would try very hard to impress and brown-nose. I did none of that. They would scurry off to do some reading on the side when things were going slow. I said boo to that. I'd just hang out in call rooms and joke around with friends who also had the same level of bitterness towards clinical medicine. We took frequent breaks.

When the day was over, I made it a point to NOT think about my patients (in reality, **** at the hospital gets done without you...everything is a stupid academic exercise at the medical student level...I learned what I needed to learn and then that's it!). I would come home and would have dinner with friends. We would try to have normal conversations but they would degenerate into "this sucks and that sucks". But that was very therapeutic.

Granted, I did not do very well on clinicals. Hence, I lost the little skirmishes. But I feel like I've won the war. I made it out alive, and as a fourth year student (well I'm done now...so even better!), I'm much happier. The bitterness and anger towards clinical medicine is a distant memory. In half a year, you will be a 4th year student and your scars will heal.

The good thing about your situation is that you finished internal medicine. Those months, for me, were by far the worst months. It's hard to look enthusiastic all the time on medicine especially when you hate the work and realize how mind-numbing it is. OB/Gyn sux too. And peds sucks as well. Psych and neuro and family are sweet cuz you can live a semi-normal life and your schedule is regular. Surgery is stupid...all you do is read a bunch of numbers during rounds (which are very short)...and trust me, I got really good at reading numbers. Tmax is 99.4 C, Tcurrent is 97.8C, BP=143/73, HR=79, etc. You look smart if you can read them off fast. Fine with me...Andy can play along...and so can you. Then you just cram surg recall on the topic prior to the surgery and you're golden. Surgery is so predictable hence it's not so bad besides the hours...but unlike medicine, you have more opportunities to run off and hide.

My friend, you have started a new Anti-Clinical medicine thread. 👍

 

[Stinger86]

I get so tired of third year, I will actually spend free time looking through my syllabus looking for loopholes that will allow me to skip for one reason or another. So far I've skipped a total of 5 days of scheduled clinic duty, with more to come in the future!

Let's hear it for using your head and being clinically lazy!!! Man, it can only get better, no doubt

 

[Gut Shot]

A K-hole, or internal medicine? You decide.

http://www.xmag.com/archives/11-04-oct03/specialk.html

 

[yaah]

I sympathize - third year was a LONG year. Mine I guess was broken up ok - started with surgery, then had a break with Psych. Ended with medicine. It does get better. 4th year will have its tough rotations, as everyone (I think) has to do some sort of Sub I. But the continuous pressure is not really there.

And Andy used the term, "Mind-numbing" which is a good way to describe it. I think, perhaps, once you spend a lot of time in clinical medicine, there are a lot of things you simply get used to, and you start to ignore how objectionable and uneducational they are. A lot of clinical medicine is routine. There are ways to make it more interesting - spend time trying to make your clinical rotations more useful to you. Sure, there will be some residents that will force you to perform a continuous string of mindless tasks, but there are many others who will see you interested in something (like seeing a colonoscopy, or spending time with a pathologist) and encourage you to do this.

And you may find, as I did, that once the clinical months end and you move on to something more appealing that suddenly the load lightens, the pathway ahead of you brightens, and the drudgery disappears. So take heart.

 

[b&ierstiefel]

Yeah...and "sucks" is also an appropriate term to describe it 🙂

You'll get through 3rd year and as you ride into the sunset, you can extend your middle finger like this cool little kid 🙂

 

[deschutes]

I finished typing up my response yesterday only to have SDN tell me "the connection was refused". Grrrrh!

Dep.Weigel, being a final-year M3 myself I think the key to surviving third year is to realize that you're really not the only person out there who thinks, "This, SUCKS." My sidekick and primary source of support is a friend who wants to go into Psych - two months into clinicals this usually-benign girl was using words I had never heard her use. And there I had thought I was being inappropriately cynical.

My first half of clerkships was spent trying to keep up with the bright-and-chirpy toy-wielding peds-wannabes and the sullen I-can-list-20-differentials-and-5-essential-investigations internist-wannabes. I was genuinely interested in learning more about all fields (not simply those in which I would kill myself trying to impress before the Dean's Letter came out), certainly not restricted to say, cardiology. I was curious about the practice of floor medicine and learning about difficult-to-grasp concepts, but apparently that wasn't enough - it was also essential that I feel perhaps slightly more important than an amoeba but certainly below the level of the janitors.

Depending on my mood, I think pathologists need to have had clinical experience. Having said that, once this year is over it will be all of that I can bear. Think of it as the karma of having to earn the right to suffer in Path 😉

I realized today that my next Path elective is only 3 weeks away. It's going to be the first Path experience since starting clinicals. I can't really summon up any more fake enthusiasm so we'll see how it goes 😱 ...but I do know that I'm already not pleased to have one of the two weeks taken up by interview time!

 

[b&ierstiefel]

...but I do know that I'm already not pleased to have one of the two weeks taken up by interview time!

wo wo wo waitaminute. are you complaining about interviews? since when do any of us complain about interviews!?!?!?

just messin, i know what you meant

 

[deschutes]

Go bed Andy.
Andy sick.
Andy not on call.
Andy no excuse.
Andy go bed!!

I messed up the 2nd IV start of my med school career Such big thick juicy veins! I wonder if she'll let me poke her again. That'll teach people to come to Emerg at 11pm for nausea and vomiting.

 

[b&ierstiefel]

Go bed Andy.
Andy sick.
Andy not on call.
Andy no excuse.
Andy go bed!!

Yes mam!

 

[Dep.Weigel]

One more night on OB call behind me and between the knowledge that in 1/2 hr I will be passed out in my own bed and all of your replies, I am feeling less... well, homicidal. After I brush my teeth I may even feel... human. Its good to know that I am not the only one who is feels that third year isn't all it is cracked up to be. I am becoming so cynical, sick of pandering to the egos/interests/insecurities of residents and interns, many of whom are younger than me, or at the very least have no interest in or idea of what is going on in the world around them. I have never met so many undecided voters in my life!

Anyway, thanks for allowing me to vent. Only 2.6 more weeks of OBGYN left. Hopefully psych will be better. I have always had a certain fondness for schizophrenics.

S.

 

[Gut Shot]

Go bed Andy.
Andy sick.
Andy not on call.
Andy no excuse.
Andy go bed!!

Little Andy
Pair of pliers
Electric wires
Spark flashes
Andy ashes

(to paraphrase a little poem that has circulated through my obviously very normal family for years)

 

[b&ierstiefel]

I am becoming so cynical, sick of pandering to the egos/interests/insecurities of residents and interns, many of whom are younger than me...

This especially was amusing to me. I took 3 years off to do a PhD. Granted, when I returned to the clinical phase, many of the interns/residents were still my age. But there was this one obnoxious little brat who had no shame when ordering us around. And the whole time I'm thinking, "Who the f**k do you think you are you little ****!" Except the words that came out of my mouth were to the effect of, "I'll get on that."

To those obnoxious little asshats, I say 3 words.

BOO

TO

YOU

!!!

 

[Non-Trad DO]

HOLY CRAP A MOLEY!!!!!!!!!!!!! 99.4C SSSSS**** 😉

 

[LADoc00]

Newsflash: I really really hate to tell people but it doesnt get any easier. It sucks, I know, but honestly it doesnt. You better love what you do, or this will hurt.....alot.

IMO, A 3rd year med student trauma rotation was a cakewalk compared to my path internship. I stepped in my first day and saw the black clouds over my desk thinking...this is perfect storm and Im on the Edmund Fitzgerald. I was right.

 

[Non-Trad DO]

😕 you do still like path though... no? I mean that is why I bumped your edited thread. Or did I fall for some sarcasm? 🙁

 

[cytoborg]

I am exhausted and afraid by the time I take my pathology elective next fall I will be reduced to a barely functioning automaton... I know that there is a light at the end of the tunnel - but lately it?s just been hard to keep up. How did you guys get through? How did you keep your spirits and interests alive during a year that seems for the most part so removed from your future career? I know misery loves company, but I really need some words of encouragement here - the other day I actually entertained the thought of just driving straight home when I was set to get food for team (a job which I actually had gladly volunteered for!). I can't tell how much of what I feel is sleep deprivation (or that hangover you get from sleeping TOO much when you are trying to make up for it), how much is disillusionment and how much is just plain aggravation at having to constantly "show enthusiasm". Ack.

Sorry for the rant. Just tell me it gets better after this...

S.

Wow, your post really hit home for me, as this is pretty much exactly how I felt during my 3rd yr. Not that I didn't like taking care of patients...as a matter of fact I enjoyed the patients...it was everything else I hated. Who really gives a rats behind whether we start a beta blocker or an ACE...whether we use heparin or coumadin...let alone look up some randomized double-blind placebo-controlled trial in our "spare time" and present it on rounds after 30+ hrs of no sleep in order to appear the superstar in front of the attending!! So much ego baloney, faking enthusiasm (yes sir I would love nothing more than to draw blood cultures at 3:30 am on an old diabetic lady with no veins!)...oh and the backstabbing (you all agree not to go back to the floor when class is cancelled...yet the gunner sneaks back and tattles.)

Excuse me, I am in the midst of medicine sub-i hell at the moment, so I may be particularly disillusioned at the moment. 😉 However I can tell you it DOES get better. Working 100+ hrs/wk on medicine is living hell. Working 100+hrs on surgpath was hard work, yes, but also fun, stimulating, and worth getting up in the morning for, because it's what I want to do, I find it completely fascinating, and the personalities are laid back and much more similar to myself, than in other fields. So keep your chin up - it WILL get better.

 

[Dep.Weigel]

LADoc, I do think there is a direct relationship between how much you love something and how much cr@p it takes to get to the point of unbridled cynicism. The other day we actually got an abbreviated slide show of pelvic pathology and my heart melted at the histology of an ovarian papillary serous adenocarcinoma the way that some people get ridiculously smitten around a fresh litter of puppies (for the record, I like puppies, too.). And Cytoborg, like you I enjoy the patients (for the most part at least). It is the practice of medicine I dislike, and the practice of teaching it, this institutional hazing, that turns my stomach. Of course, the crack mommas who arrive with placental abruption secondary to a pregnancy complicated by prostitution and poly substance abuse require their own special kind of patience.

I was wise enough to stick a couple of beers in the fridge before napping. That in itself shows that I have maintained some amount of sanity and good sense.

 

[LADoc00]

The hazing is only bad when you are on the receiving end of it, once you move over to the "dom" role, I found it more fun.

Read the Story of O for inspiration.

 

[deschutes]

I think LADoc00 is right - we're going into path not because it's any easier, but because we chose it. Yah!